ear, nose, mouth

vertigo

spinning sensation

ear function

• outer ear - collect sound

• middle ear - conduct sound

• inner ear - convert vibrations into nerve impulses

sensorineural hearing loss

• damage to inner ear

• causes

  • loud noises

  • aging

conductive hearing loss

• damage to outer and middle ear

• sound waves unable to get into middle ear

• caused by

  • infection

  • earwax buildup

  • punctured eardrum

  • fluid in middle ear

presbycusis

age related gradual progressive sensorineural hearing loss

otoscopic exam

normal - pearly gray

abnormal - red, bulging, perforations

mastoiditis

inflamed auricle

rinne test

• compare bone and air conduction

• tuning fork on mastoid bone, signal when they can’t hear

• tuning fork at ear canal, signal when they can’t hear

weber test

• which car can hear best

• tuning fork middle of head, which ear do they hear it best

otitis externa

inflamed auditory canal + external surface

acute otitis media

inflamed middle ear

cranial nerves for this segment

• CN VII (vestibulocochlear) - whisper behind patient

• CN I (olfactory) - identify scent

• CN IX (glossopharyngeal) - gag reflex and swallow

• CN X (vagus) - pharynx, larynx sensation

• CN XII (hypoglossal) - tongue movement

epistaxis

nosebleed

sinuses assessment

palpate frontal and maxillary sinuses for tenderness

drainage

• normal - clear and thin

• abnormal - purulent, foul smelling

tonsil grading

0 = absent

1+ = visible

2+ = half way between soft pallet and uvula

3+ = touching uvula

4+ = touching each other (airway concern)

age related considerations for mouth

• decreased saliva

• tooth loss

• gum recession

• presbycusis

• decreased ability to smell and taste

sinusitis

bacterial infection of paranasal sinuses (one or more)

pharyngitis

infection of tonsils or posterior pharynx